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Tsai YY, Cheng D, Huang SW, Hung SJ, Wang YF, Lin YJ, Tsai HP, Chu JJH, Wang JR. The molecular epidemiology of a dengue virus outbreak in Taiwan: population wide versus infrapopulation mutation analysis. PLoS Negl Trop Dis 2024; 18:e0012268. [PMID: 38870242 PMCID: PMC11207123 DOI: 10.1371/journal.pntd.0012268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 06/26/2024] [Accepted: 06/03/2024] [Indexed: 06/15/2024] Open
Abstract
Dengue virus (DENV) causes approximately 390 million dengue infections worldwide every year. There were 22,777 reported DENV infections in Tainan, Taiwan in 2015. In this study, we sequenced the C-prM-E genes from 45 DENV 2015 strains, and phylogenetic analysis based on C-prM-E genes revealed that all strains were classified as DENV serotype 2 Cosmopolitan genotype. Sequence analysis comparing different DENV-2 genotypes and Cosmopolitan DENV-2 sequences prior to 2015 showed a clade replacement event in the DENV-2 Cosmopolitan genotype. Additionally, a major substitution C-A314G (K73R) was found in the capsid region which may have contributed to the clade replacement event. Reverse genetics virus rgC-A314G (K73R) showed slower replication in BHK-21 and C6/36 cells compared to wildtype virus, as well as a decrease in NS1 production in BHK-21-infected cells. After a series of passaging, the C-A314G (K73R) mutation reverted to wildtype and was thus considered to be unstable. Next generation sequencing (NGS) of three sera collected from a single DENV2-infected patient at 1-, 2-, and 5-days post-admission was employed to examine the genetic diversity over-time and mutations that may work in conjunction with C-A314G (K73R). Results showed that the number of haplotypes decreased with time in the DENV-infected patient. On the fifth day after admission, two new haplotypes emerged, and a single non-synonymous NS4A-L115I mutation was identified. Therefore, we have identified a persistent mutation C-A314G (K73R) in all of the DENV-2 isolates, and during the course of an infection, a single new non-synonymous mutation in the NS4A region appears in the virus population within a single host. The C-A314G (K73R) thus may have played a role in the DENV-2 2015 outbreak while the NS4A-L115I may be advantageous during DENV infection within the host.
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Affiliation(s)
- You-Yuan Tsai
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Dayna Cheng
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sheng-Wen Huang
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Tainan, Taiwan
| | - Su-Jhen Hung
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Tainan, Taiwan
| | - Ya-Fang Wang
- National Mosquito-Borne Diseases Control Research Center, National Health Research Institutes, Tainan, Taiwan
| | - Yih-Jyh Lin
- Division of General Surgery, Department of Surgery, College of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Huey-Pin Tsai
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Justin Jang Hann Chu
- Infectious Diseases Translational Research Program and Department of Microbiology and Immunology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jen-Ren Wang
- Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Pathology, National Cheng Kung University Hospital, Tainan, Taiwan
- Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Center of Infectious Disease and Signaling Research, National Cheng Kung University, Tainan, Taiwan
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2
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A New HIV-1 K 28E 32-Reverse Transcriptase Variant Associated with the Rapid Expansion of CRF07_BC among Men Who Have Sex with Men. Microbiol Spectr 2022; 10:e0254522. [PMID: 36214682 PMCID: PMC9604004 DOI: 10.1128/spectrum.02545-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
HIV-1 CRF07_BC originated among injection drug users (IDUs) in China. After diffusing into men who have sex with men (MSM), CRF07_BC has shown a rapid expansion in this group; however, the mechanism remains unclear. Here, we identified a new K28E32 variant of CRF07_BC that was characterized by five specific mutations (E28K, K32E, E248V, K249Q, and T338S) in reverse transcriptase. This variant was mainly prevalent among MSM, and was overrepresented in transmission clusters, suggesting that it could have driven the rapid expansion of CRF07_BC in MSM, though founder effects cannot be ruled out. It was descended from an evolutionary intermediate accumulating four specific mutations and formed an independent phylogenetic node with an estimated origin time in 2003. The K28E32 variant was demonstrated to have significantly higher in vitro HIV-1 replication ability than the wild type. Mutations E28K and K32E play a critical role in the improvement of in vitro HIV-1 replication ability, reflected by improved reverse transcription activity. The results could allow public health officials to use this marker (especially E28K and K32E mutations in the reverse transcriptase (RT) coding region) to target prevention measures prioritizing MSM population and persons infected with this variant for test and treat initiatives. IMPORTANCE HIV-1 has very high mutation rate that is correlated with the survival and adaption of the virus. The variants with higher transmissibility may be more selective advantage than the strains with higher virulence. Several HIV-1 variants were previously demonstrated to be correlated with higher viral load and lower CD4 T cell count. Here, we first identified a new variant (the K28E32 variant) of HIV-1 CRF07_BC, described its origin and evolutionary dynamics, and demonstrated its higher in vitro HIV-1 replication ability than the wild type. We demonstrated that five RT mutations (especially E28K and K32E) significantly improve in vitro HIV-1 replication ability. The appearance of the new K28E32 variant was associated with the rapidly increasing prevalence of CRF07_BC among MSM.
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Friedman SR, Williams LD, Jordan AE, Walters S, Perlman DC, Mateu-Gelabert P, Nikolopoulos GK, Khan MR, Peprah E, Ezell J. Toward a Theory of the Underpinnings and Vulnerabilities of Structural Racism: Looking Upstream from Disease Inequities among People Who Use Drugs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7453. [PMID: 35742699 PMCID: PMC9224240 DOI: 10.3390/ijerph19127453] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 12/04/2022]
Abstract
Structural racism is increasingly recognized as a key driver of health inequities and other adverse outcomes. This paper focuses on structural racism as an "upstream" institutionalized process, how it creates health inequities and how structural racism persists in spite of generations of efforts to end it. So far, "downstream" efforts to reduce these health inequities have had little success in eliminating them. Here, we attempt to increase public health awareness of structural racism and its institutionalization and sociopolitical supports so that research and action can address them. This paper presents both a theoretic and an analytic approach to how structural racism contributes to disproportionate rates of HIV/AIDS and related diseases among oppressed populations. We first discuss differences in disease and health outcomes among people who use drugs (PWUD) and other groups at risk for HIV from different racial and ethnic populations. The paper then briefly analyzes the history of racism; how racial oppression, class, gender and other intersectional divisions interact to create health inequities; and how structural racism is institutionalized in ways that contribute to disease disparities among people who use drugs and other people. It examines the processes, institutions and other structures that reinforce structural racism, and how these, combined with processes that normalize racism, serve as barriers to efforts to counter and dismantle the structural racism that Black, indigenous and Latinx people have confronted for centuries. Finally, we discuss the implications of this analysis for public health research and action to undo racism and to enhance the health of populations who have suffered lifetimes of racial/ethnic oppression, with a focus on HIV/AIDS outcomes.
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Affiliation(s)
- Samuel R. Friedman
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA;
| | - Leslie D. Williams
- Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL 60612, USA;
| | - Ashly E. Jordan
- Center for Drug Use and HIV/HCV Research, New York, NY 10003, USA;
| | - Suzan Walters
- Department of Epidemiology, New York University School of Global Public Health, New York, NY 10003, USA; (S.W.); (E.P.)
| | - David C. Perlman
- Icahn School of Medicine at Mount Sinai, New York, NY 10003, USA;
| | - Pedro Mateu-Gelabert
- Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10027, USA;
| | | | - Maria R. Khan
- Department of Population Health, New York University Grossman School of Medicine, New York, NY 10016, USA;
| | - Emmanuel Peprah
- Department of Epidemiology, New York University School of Global Public Health, New York, NY 10003, USA; (S.W.); (E.P.)
| | - Jerel Ezell
- Africana Studies and Research Center, Cornell University, Ithaca, NY 14850, USA;
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Thomazella MV, Lima Neto QA, Duarte Junior FF, Jorge FA, de Castro Moreira D, Leal Junior AD, Presibella MM, Riediger IN, da Silva RA, de Carvalho IMVG, Bertolini DA. Insights on Zika virus envelope gene conservation in American outbreaks. Braz J Microbiol 2020; 51:1601-1605. [PMID: 32749573 PMCID: PMC7688768 DOI: 10.1007/s42770-020-00349-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 07/25/2020] [Indexed: 10/23/2022] Open
Abstract
Phylogenetic studies with Zika virus (ZIKV) have been conducted in Brazil. In this study, we sequenced 8 new sequences of the ZIKV envelope (E) gene from strains of cases from the Paraná and Mato Grosso do Sul states in 2016. A low phylogenetic signal was observed, with more than 40% of unresolved quartets, and the Maximum Likelihood Tree grouped all sequences in the Brazilian branches within the Asian genotype. In addition, a Shannon entropy analysis was conducted, showing a high stability in the E protein through the ZIKV polyprotein. Taken together, these results suggest a high degree of conservation in the ZIKV E gene from the recent American outbreaks.
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Affiliation(s)
- Mateus V Thomazella
- Laboratório de Virologia Clínica, Universidade Estadual de Maringá - UEM, Avenida Colombo, 5790, Maringá, Paraná, 87020-900, Brazil.
| | - Quirino A Lima Neto
- Laboratório de Virologia Clínica, Universidade Estadual de Maringá - UEM, Avenida Colombo, 5790, Maringá, Paraná, 87020-900, Brazil
| | - Francisco F Duarte Junior
- Laboratório de Virologia Clínica, Universidade Estadual de Maringá - UEM, Avenida Colombo, 5790, Maringá, Paraná, 87020-900, Brazil
| | - Fernando A Jorge
- Laboratório de Virologia Clínica, Universidade Estadual de Maringá - UEM, Avenida Colombo, 5790, Maringá, Paraná, 87020-900, Brazil
| | - Déborah de Castro Moreira
- Laboratório de Virologia Clínica, Universidade Estadual de Maringá - UEM, Avenida Colombo, 5790, Maringá, Paraná, 87020-900, Brazil
| | - Amauri D Leal Junior
- Laboratório de Virologia Clínica, Universidade Estadual de Maringá - UEM, Avenida Colombo, 5790, Maringá, Paraná, 87020-900, Brazil
| | - Mayra M Presibella
- Laboratório Central do Estado do Paraná - LACEN-PR, Curitiba, Paraná, Brazil
| | - Irina N Riediger
- Laboratório Central do Estado do Paraná - LACEN-PR, Curitiba, Paraná, Brazil
| | - Rafael A da Silva
- Instituto Butantan, São Paulo, São Paulo, Brazil
- Universidade Federal de São Paulo - UNIFESP/EPM, São Paulo, São Paulo, Brazil
| | - Isabel Maria V G de Carvalho
- Instituto Butantan, São Paulo, São Paulo, Brazil
- Universidade Federal de São Paulo - UNIFESP/EPM, São Paulo, São Paulo, Brazil
| | - Dennis A Bertolini
- Laboratório de Virologia Clínica, Universidade Estadual de Maringá - UEM, Avenida Colombo, 5790, Maringá, Paraná, 87020-900, Brazil
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Cholette F, Joy J, Pelcat Y, Thompson LH, Pilon R, Ho J, Capina R, Archibald C, Blanchard JF, Emmanuel F, Reza T, Dar N, Harrigan R, Kim J, Sandstrom P. HIV-1 phylodynamic analysis among people who inject drugs in Pakistan correlates with trends in illicit opioid trade. PLoS One 2020; 15:e0237560. [PMID: 32857765 PMCID: PMC7454939 DOI: 10.1371/journal.pone.0237560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 07/30/2020] [Indexed: 12/26/2022] Open
Abstract
Pakistan is considered by the World Health Organization to currently have a "concentrated" HIV-1 epidemic due to a rapid rise in infections among people who inject drugs (PWID). Prevalence among the country's nearly 105,000 PWID is estimated to be 37.8% but has been shown to be higher in several large urban centers. A lack of public health resources, the common use of professional injectors and unsafe injection practices are believed to have fueled the outbreak. Here we evaluate the molecular characteristics of HIV-1 sequences (n = 290) from PWID in several Pakistani cities to examine transmission dynamics and the association between rates of HIV-1 transmission with regards to regional trends in opioid trafficking. Tip-to-tip (patristic) distance based phylogenetic cluster inferences and BEAST2 Bayesian phylodynamic analyses of time-stamped data were performed on HIV-1 pol sequences generated from dried blood spots collected from 1,453 PWID as part of a cross-sectional survey conducted in Pakistan during 2014/2015. Overall, subtype A1 strains were dominant (75.2%) followed by CRF02_AG (14.1%), recombinants/unassigned (7.2%), CRF35_AD (2.1%), G (1.0%) and C (0.3%). Nearly three quarters of the PWID HIV-1 sequences belonged to one of five distinct phylogenetic clusters. Just below half (44.4%) of individuals in the largest cluster (n = 118) did seek help injecting from professional injectors which was previously identified as a strong correlate of HIV-1 infection. Spikes in estimated HIV-1 effective population sizes coincided with increases in opium poppy cultivation in Afghanistan, Pakistan's western neighbor. Structured coalescent analysis was undertaken in order to investigate the spatial relationship of HIV-1 transmission among the various cities under study. In general terms, our analysis placed the city of Larkana at the center of the PWID HIV-1 epidemic in Pakistan which is consistent with previous epidemiological data.
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Affiliation(s)
- François Cholette
- National HIV and Retrovirology Laboratories, National Microbiology Laboratory at the JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jeffrey Joy
- British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Bioinformatics Programme, University of British Columbia, Vancouver, British Columbia, Canada
| | - Yann Pelcat
- Public Health Risk Sciences Division, National Microbiology Laboratory, Public Health Agency of Canada, Saint-Hyacinthe, Québec, Canada
| | - Laura H. Thompson
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Richard Pilon
- National HIV and Retrovirology Laboratories, National Microbiology Laboratory at the JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - John Ho
- National HIV and Retrovirology Laboratories, National Microbiology Laboratory at the JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Rupert Capina
- National HIV and Retrovirology Laboratories, National Microbiology Laboratory at the JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Chris Archibald
- Centre for Communicable Diseases and Infection Control, Surveillance and Epidemiology Division, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - James F. Blanchard
- Centre for Global Public Health, University of Manitoba, Winnipeg, Canada
| | - Faran Emmanuel
- Centre for Global Public Health, University of Manitoba, Winnipeg, Canada
| | - Tahira Reza
- Centre for Global Public Health, Pakistan, Chak Shahzad, Islamabad, Pakistan
| | - Nosheen Dar
- Canada-Pakistan HIV/AIDS Surveillance Project, Islamabad, Pakistan
| | - Richard Harrigan
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - John Kim
- National HIV and Retrovirology Laboratories, National Microbiology Laboratory at the JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Paul Sandstrom
- National HIV and Retrovirology Laboratories, National Microbiology Laboratory at the JC Wilt Infectious Diseases Research Centre, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
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6
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MacLean OA, Orton RJ, Singer JB, Robertson DL. No evidence for distinct types in the evolution of SARS-CoV-2. Virus Evol 2020; 6:veaa034. [PMID: 32817804 PMCID: PMC7197565 DOI: 10.1093/ve/veaa034] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
A recent study by Tang et al. claimed that two major types of severe acute respiratory syndrome-coronavirus-2 (CoV-2) had evolved in the ongoing CoV disease-2019 pandemic and that one of these types was more 'aggressive' than the other. Given the repercussions of these claims and the intense media coverage of these types of articles, we have examined in detail the data presented by Tang et al., and show that the major conclusions of that paper cannot be substantiated. Using examples from other viral outbreaks, we discuss the difficulty in demonstrating the existence or nature of a functional effect of a viral mutation, and we advise against overinterpretation of genomic data during the pandemic.
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Affiliation(s)
- Oscar A MacLean
- MRC-University of Glasgow Centre for Virus Research (CVR), Garscube Campus, 464 Bearsden Road, Glasgow G61 1QH, UK
| | - Richard J Orton
- MRC-University of Glasgow Centre for Virus Research (CVR), Garscube Campus, 464 Bearsden Road, Glasgow G61 1QH, UK
| | - Joshua B Singer
- MRC-University of Glasgow Centre for Virus Research (CVR), Garscube Campus, 464 Bearsden Road, Glasgow G61 1QH, UK
| | - David L Robertson
- MRC-University of Glasgow Centre for Virus Research (CVR), Garscube Campus, 464 Bearsden Road, Glasgow G61 1QH, UK
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Farooq SA, Rasooly MH, Abidi SH, Modjarrad K, Ali S. Opium trade and the spread of HIV in the Golden Crescent. Harm Reduct J 2017; 14:47. [PMID: 28732503 PMCID: PMC5521118 DOI: 10.1186/s12954-017-0170-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 06/22/2017] [Indexed: 11/10/2022] Open
Abstract
The Golden Crescent region of South Asia-comprising Afghanistan, Iran, and Pakistan-is a principal global site for opium production and distribution. Over the past few decades, war, terrorism, and a shifting political landscape have facilitated an active heroin trade throughout the region. Protracted conflict has exacerbated already dire socio-economic conditions and political strife within the region and contributed to a consequent rise in opiate trafficking and addiction among the region's inhabitants. The worsening epidemic of injection drug use has paralleled the rising incidence of HIV and other blood-borne infections in the region and drawn attention to the broader implications of the growing opiate trade in the Golden Crescent. The first step in addressing drug use is to recognize that it is not a character flaw but a form of mental illness, hence warranting humane treatment of drug users. It is also recommended that the governments of the Golden Crescent countries encourage substitution of opium with licit crops and raise awareness among the general public about the perils of opium use.
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Affiliation(s)
| | | | - Syed Hani Abidi
- Aga Khan University, Karachi, Pakistan.,Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Kayvon Modjarrad
- US Military HIV Research Program, Walter Reed Army Institute of Research, Silver Spring, USA
| | - Syed Ali
- Department of Biomedical Sciences, Nazarbayev School of Medicine, Nazarbayev University, Astana, Kazakhstan. .,Dow University of Health Sciences, Karachi, Pakistan.
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Chen Y, Hora B, DeMarco T, Shah SA, Ahmed M, Sanchez AM, Su C, Carter M, Stone M, Hasan R, Hasan Z, Busch MP, Denny TN, Gao F. Fast Dissemination of New HIV-1 CRF02/A1 Recombinants in Pakistan. PLoS One 2016; 11:e0167839. [PMID: 27973597 PMCID: PMC5156399 DOI: 10.1371/journal.pone.0167839] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 11/21/2016] [Indexed: 12/21/2022] Open
Abstract
A number of HIV-1 subtypes are identified in Pakistan by characterization of partial viral gene sequences. Little is known whether new recombinants are generated and how they disseminate since whole genome sequences for these viruses have not been characterized. Near full-length genome (NFLG) sequences were obtained by amplifying two overlapping half genomes or next generation sequencing from 34 HIV-1-infected individuals in Pakistan. Phylogenetic tree analysis showed that the newly characterized sequences were 16 subtype As, one subtype C, and 17 A/G recombinants. Further analysis showed that all 16 subtype A1 sequences (47%), together with the vast majority of sequences from Pakistan from other studies, formed a tight subcluster (A1a) within the subtype A1 clade, suggesting that they were derived from a single introduction. More in-depth analysis of 17 A/G NFLG sequences showed that five shared similar recombination breakpoints as in CRF02 (15%) but were phylogenetically distinct from the prototype CRF02 by forming a tight subcluster (CRF02a) while 12 (38%) were new recombinants between CRF02a and A1a or a divergent A1b viruses. Unique recombination patterns among the majority of the newly characterized recombinants indicated ongoing recombination. Interestingly, recombination breakpoints in these CRF02/A1 recombinants were similar to those in prototype CRF02 viruses, indicating that recombination at these sites more likely generate variable recombinant viruses. The dominance and fast dissemination of new CRF02a/A1 recombinants over prototype CRF02 suggest that these recombinant have more adapted and may become major epidemic strains in Pakistan.
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Affiliation(s)
- Yue Chen
- Duke Human Vaccine Institute, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Bhavna Hora
- Duke Human Vaccine Institute, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Todd DeMarco
- Duke Human Vaccine Institute, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | | | | | - Ana M. Sanchez
- Duke Human Vaccine Institute, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Chang Su
- Duke Human Vaccine Institute, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Meredith Carter
- Duke Human Vaccine Institute, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Mars Stone
- Blood Systems Research Institute, San Francisco, California, United States of America
| | - Rumina Hasan
- Department of Pathology, Aga Khan University, Karachi, Pakistan
- Department of Microbiology, Aga Khan University, Karachi, Pakistan
| | - Zahra Hasan
- Department of Pathology, Aga Khan University, Karachi, Pakistan
- Department of Microbiology, Aga Khan University, Karachi, Pakistan
| | - Michael P. Busch
- Blood Systems Research Institute, San Francisco, California, United States of America
| | - Thomas N. Denny
- Duke Human Vaccine Institute, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
| | - Feng Gao
- Duke Human Vaccine Institute, Department of Medicine, Duke University Medical Center, Durham, North Carolina, United States of America
- * E-mail:
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9
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Eybpoosh S, Bahrampour A, Karamouzian M, Azadmanesh K, Jahanbakhsh F, Mostafavi E, Zolala F, Haghdoost AA. Spatio-Temporal History of HIV-1 CRF35_AD in Afghanistan and Iran. PLoS One 2016; 11:e0156499. [PMID: 27280293 PMCID: PMC4900578 DOI: 10.1371/journal.pone.0156499] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 05/16/2016] [Indexed: 01/28/2023] Open
Abstract
HIV-1 Circulating Recombinant Form 35_AD (CRF35_AD) has an important position in the epidemiological profile of Afghanistan and Iran. Despite the presence of this clade in Afghanistan and Iran for over a decade, our understanding of its origin and dissemination patterns is limited. In this study, we performed a Bayesian phylogeographic analysis to reconstruct the spatio-temporal dispersion pattern of this clade using eligible CRF35_AD gag and pol sequences available in the Los Alamos HIV database (432 sequences available from Iran, 16 sequences available from Afghanistan, and a single CRF35_AD-like pol sequence available from USA). Bayesian Markov Chain Monte Carlo algorithm was implemented in BEAST v1.8.1. Between-country dispersion rates were tested with Bayesian stochastic search variable selection method and were considered significant where Bayes factor values were greater than three. The findings suggested that CRF35_AD sequences were genetically similar to parental sequences from Kenya and Uganda, and to a set of subtype A1 sequences available from Afghan refugees living in Pakistan. Our results also showed that across all phylogenies, Afghan and Iranian CRF35_AD sequences formed a monophyletic cluster (posterior clade credibility> 0.7). The divergence date of this cluster was estimated to be between 1990 and 1992. Within this cluster, a bidirectional dispersion of the virus was observed across Afghanistan and Iran. We could not clearly identify if Afghanistan or Iran first established or received this epidemic, as the root location of this cluster could not be robustly estimated. Three CRF35_AD sequences from Afghan refugees living in Pakistan nested among Afghan and Iranian CRF35_AD branches. However, the CRF35_AD-like sequence available from USA diverged independently from Kenyan subtype A1 sequences, suggesting it not to be a true CRF35_AD lineage. Potential factors contributing to viral exchange between Afghanistan and Iran could be injection drug networks and mass migration of Afghan refugees and labours to Iran, which calls for extensive preventive efforts.
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Affiliation(s)
- Sana Eybpoosh
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Bahrampour
- Modeling in Health Research Centre, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Karamouzian
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- School of Population and Public Health, Faculty of Medicine, University of British Colombia, Vancouver, BC, Canada
| | | | | | - Ehsan Mostafavi
- Epidemiology Department, Pasteur Institute of Iran, Tehran, Iran
- Emerging and Reemerging Infectious Diseases Research Centre, Pasteur Institute of Iran, Akanlu, Kabudar Ahang, Hamadan, Iran
| | - Farzaneh Zolala
- Modeling in Health Research Centre, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Ali Akbar Haghdoost
- Regional Knowledge Hub, and WHO Collaborating Centre for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- * E-mail:
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10
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Shah AA, Abidi SH, Kalish ML, Vermund SH, Ali S. Viral co-infections in high-risk communities of Pakistan. Lancet HIV 2015; 2:e124-e125. [PMID: 26424672 DOI: 10.1016/s2352-3018(15)00039-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 02/24/2015] [Indexed: 06/05/2023]
Affiliation(s)
- Adil A Shah
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi-Pakistan
| | - Syed H Abidi
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi-Pakistan.
| | - Marcia L Kalish
- Vanderbilt Institutes of Global Health, Vanderbilt University, Vanderbilt, Nashville, US
| | - Sten H Vermund
- Vanderbilt Institutes of Global Health, Vanderbilt University, Vanderbilt, Nashville, US
| | - Syed Ali
- Department of Biomedical Sciences, Nazarbayev School of Medicine, Nazarbayev University, Astana, Kazakhstan
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11
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Abstract
Objective The aim of this study was to examine the course of time-dependent evolution of HIV-1 subtype A on a global level, especially with respect to the dynamics of immunogenic HIV gag epitopes. Methods We used a total of 1,893 HIV-1 subtype A gag sequences representing a timeline from 1985 through 2010, and 19 different countries in Africa, Europe and Asia. The phylogenetic relationship of subtype A gag and its epidemic dynamics was analysed through a Maximum Likelihood tree and Bayesian Skyline plot, genomic variability was measured in terms of G→A substitutions and Shannon entropy, and the time-dependent evolution of HIV subtype A gag epitopes was examined. Finally, to confirm observations on globally reported HIV subtype A sequences, we analysed the gag epitope data from our Kenyan, Pakistani, and Afghan cohorts, where both cohort-specific gene epitope variability and HLA restriction profiles of gag epitopes were examined. Results The most recent common ancestor of the HIV subtype A epidemic was estimated to be 1956±1. A period of exponential growth began about 1980 and lasted for approximately 7 years, stabilized for 15 years, declined for 2–3 years, then stabilized again from about 2004. During the course of evolution, a gradual increase in genomic variability was observed that peaked in 2005–2010. We observed that the number of point mutations and novel epitopes in gag also peaked concurrently during 2005–2010. Conclusion It appears that as the HIV subtype A epidemic spread globally, changing population immunogenetic pressures may have played a role in steering immune-evolution of this subtype in new directions. This trend is apparent in the genomic variability and epitope diversity of HIV-1 subtype A gag sequences.
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Samo RN, Altaf A, Agha A, Pasha O, Rozi S, Memon A, Azam S, Blevins M, Vermund SH, Shah SA. High HIV incidence among persons who inject drugs in Pakistan: greater risk with needle sharing and injecting frequently among the homeless. PLoS One 2013; 8:e81715. [PMID: 24358123 PMCID: PMC3864804 DOI: 10.1371/journal.pone.0081715] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Accepted: 10/26/2013] [Indexed: 11/18/2022] Open
Abstract
Background The incidence of HIV among persons who inject drugs (PWIDU) has fallen in many nations, likely due to successes of clean needle/syringe exchange and substance abuse treatment and service programs. However in Pakistan, prevalence rates for PWID have risen dramatically. In several cities, prevalence exceeded 20% by 2009 compared to a 2003 baseline of just 0.5%. However, no cohort study of PWID has ever been conducted. Methods We enrolled a cohort of 636 HIV seronegative PWID registered with three drop-in centers that focus on risk reduction and basic social services in Karachi. Recruitment began in 2009 (March to June) and PWID were followed for two years. We measured incidence rates and risk factors associated with HIV seroconversion. Results Incidence of HIV was 12.4 per 100 person-years (95% exact Poisson confidence interval [CI]: 10.3–14.9). We followed 474 of 636 HIV seronegative persons (74.5%) for two years, an annual loss to follow-up of <13 per 100 person years. In multivariable Cox regression analysis, HIV seroconversion was associated with non-Muslim religion (Adjusted risk ratio [ARR] = 1.7, 95%CI:1.4, 2.7, p = 0.03), sharing of syringes (ARR = 2.3, 95%CI:1.5, 3.3, p<0.0001), being homeless (ARR = 1.7, 95%CI:1.1, 2.5, p = 0.009), and daily injection of drugs (ARR = 1.1, 95%CI:1.0, 1.3, p = 0.04). Conclusions Even though all members of the cohort of PWID were attending risk reduction programs, the HIV incidence rate was very high in Karachi from 2009–2011. The project budget was low, yet we were able to retain three-quarters of the population over two years. Absence of opiate substitution therapy and incomplete needle/syringe exchange coverage undermines success in HIV risk reduction.
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Affiliation(s)
- Rab Nawaz Samo
- Bridge Consultants Foundation, Karachi, Pakistan
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Arshad Altaf
- Bridge Consultants Foundation, Karachi, Pakistan
- * E-mail:
| | - Ajmal Agha
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Omrana Pasha
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Shafquat Rozi
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | | | | | - Meridith Blevins
- Vanderbilt Institute for Global Health and Departments of Biostatistics & Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
| | - Sten H. Vermund
- Vanderbilt Institute for Global Health and Departments of Biostatistics & Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee, United States of America
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13
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Abidi SH, Shahid A, Lakhani LS, Khanani MR, Ojwang P, Okinda N, Shah R, Abbas F, Rowland-Jones S, Ali S. Population-specific evolution of HIV Gag epitopes in genetically diverged patients. INFECTION GENETICS AND EVOLUTION 2013; 16:78-86. [PMID: 23403357 DOI: 10.1016/j.meegid.2013.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 01/30/2013] [Accepted: 02/03/2013] [Indexed: 10/27/2022]
Abstract
BACKGROUND Under the host selection pressure HIV evolves rapidly to override crucial steps in the antigen presentation pathway. This allows the virus to escape binding and recognition by cytotoxic T lymphocytes. Selection pressures on HIV can be unique depending on the immunogenetics of host populations. It is therefore logical to hypothesize that the virus evolving in a given population will carry signature mutations that will allow it to survive in that particular host milieu. OBJECTIVES The aim of this study was to perform a comparative analysis of HIV-1 Gag subtype A sequences from two genetically diverged populations, namely, Kenyan and Pakistani. We analyzed unique mutations that could intercept the antigen processing pathway and potentially change the repertoire of Gag epitopes in each study group. METHODS Twenty-nine Kenyan and 56 Pakistani samples from HIV-1 subtype A-infected patients were used in this study. The HIV-1 gag region p24 and p2p7p1p6 was sequenced and mutations affecting proteasomal degradation, TAP binding, HLA binding and CTL epitope generation, were analyzed using the in silico softwares NetChop and MAPPP, TAPPred, nHLAPred and CTLPred, respectively. RESULTS Certain mutations unique to either Pakistani or Kenyan patients were observed to affect sites for proteasomal degradation, TAP binding, and HLA binding. As a consequence of these mutations, epitope pattern in these populations was altered. CONCLUSION Unique selection pressures can steer the direction of viral epitope evolution in the host populations. Population-specific HIV epitopes have to be taken into account while designing treatment as well as vaccine for HIV.
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Affiliation(s)
- Syed H Abidi
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
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14
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Khanani MR, Somani M, Rehmani SS, Veras NMC, Salemi M, Ali SH. The spread of HIV in Pakistan: bridging of the epidemic between populations. PLoS One 2011; 6:e22449. [PMID: 21799857 PMCID: PMC3143131 DOI: 10.1371/journal.pone.0022449] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2011] [Accepted: 06/22/2011] [Indexed: 11/19/2022] Open
Abstract
In the last two decades, ‘concentrated epidemics’ of human immunodeficiency virus (HIV) have established in several high risk groups in Pakistan, including Injecting Drug Users (IDUs) and among men who have sex with men (MSM). To explore the transmission patterns of HIV infection in these major high-risk groups of Pakistan, 76 HIV samples were analyzed from MSM, their female spouses and children, along with 26 samples from a previously studied cohort of IDUs. Phylogenetic analysis of HIV gag gene sequences obtained from these samples indicated a substantial degree of intermixing between the IDU and MSM populations, suggesting a bridging of HIV infection from IDUs, via MSM, to the MSM spouses and children. HIV epidemic in Pakistan is now spreading to the female spouses and offspring of bisexual MSM. HIV control and awareness programs must be refocused to include IDUs, MSM, as well as bisexual MSM, and their spouses and children.
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Affiliation(s)
- Muhammad R. Khanani
- Department of Microbiology, Dow University of Health Sciences, Karachi, Pakistan
| | - Mehreen Somani
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | - Sadiq S. Rehmani
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
| | - Nazle M. C. Veras
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine and Emerging Pathogens Institute, Jacksonville, Florida, United States of America
| | - Marco Salemi
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine and Emerging Pathogens Institute, Jacksonville, Florida, United States of America
| | - Syed H. Ali
- Department of Microbiology, Dow University of Health Sciences, Karachi, Pakistan
- Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, Pakistan
- * E-mail:
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15
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Abstract
The current study was conducted to explore the origins of the HIV epidemics among the Afghan refugees in Pakistan and the native Afghans in Afghanistan. Phylogenetic analysis of HIV gag gene from 40 samples showed diverse HIV variants, originating from a number of countries. Intermixing of diverse HIV variants among Afghans may give rise to seeding of infections with rare HIV strains which may pose serious challenges for the treatment and control of infection.
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Epidemiologic links between drug use and HIV epidemics: an international perspective. J Acquir Immune Defic Syndr 2010; 55 Suppl 1:S10-6. [PMID: 21045593 DOI: 10.1097/qai.0b013e3181f9c0c9] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Injecting use of heroin has been the highest risk substance use behavior for HIV since the beginning of the pandemic. These risks extend beyond individual levels to networks of drugs users and to wider social contexts that have been referred to collectively as the risk environment. Investigations of individual, network, and risk environment level associations with heroin availability, use, and subsequent spread among injecting drug users (IDUs) have been conducted in multiple settings, but much less is known about the world's center of illicit opium production and heroin exports-Afghanistan. Recent outbreaks of injecting drug use and of HIV infection attributed to IDUs in several African countries suggest that heroin use is expanding into new regions. This article explores the epidemiology of HIV among drug users in several risk environments, the epidemiology of heroin and its associations with HIV outbreaks among IDUs in Central Asia and the Commonwealth of Independent States, and the drug use and IDUs outbreaks now emerging in Africa. The dearth of targeted, evidence-and human rights-based responses to these epidemics is explored as a structural driver of HIV spread in these settings.
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